| NPI | 1043278450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 23103) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA MD.010050) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-04-19 |